National Center for Complementary and Integrative Health (NCCIH)

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European Elder

Common Names: 
European elder, black elder, elder, elderberry, elder flower, sambucus
Latin Name: 
Sambucus nigra
European Elder © Steven Foster

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This fact sheet provides basic information about European elder—common names, what the science says, potential side effects and cautions, and resources for more information.

European elder is a tree native to Europe and parts of Asia and Africa, and it also grows in the United States. There are several different types of elder, such as American elder, but European elder is the type most often used as a supplement. Parts of the elder tree—such as the berries and flowers—have historically been used for pain, swelling, infections, coughs, and skin conditions. Current folk or traditional uses of elderberry and elder flower include flu, colds, fevers, constipation, and sinus infections.

The dried flowers (elder flower) and the cooked blue/black berries (elderberry) of the European elder tree are used in teas, liquid extracts, and capsules.


What the Science Says

  • Although some small studies show that elderberry may relieve flu symptoms, the evidence is not strong enough to support this use of the berry.
  • A few studies have suggested that a product containing elder flower and other herbs can help treat sinus infections when used with antibiotics, but further research is needed to confirm any benefit.
  • No reliable information is available on the effectiveness of elderberry and elder flower for other uses.


Side Effects and Cautions

  • Uncooked or unripe elderberries are toxic and cause nausea, vomiting, or severe diarrhea. Only the blue/black berries of elder are edible.
  • Because of elder flower’s possible diuretic effects, use caution if taking it with drugs that increase urination.
  • Tell all your health care providers about any complementary health approaches you use. Give them a full picture of what you do to manage your health. This helps to ensure coordinated and safe care.


NCCIH Clearinghouse

The NCCIH Clearinghouse provides information on NCCIH and complementary and integrative health approaches, including publications and searches of Federal databases of scientific and medical literature. The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.

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A service of the National Library of Medicine (NLM), PubMed® contains publication information and (in most cases) brief summaries of articles from scientific and medical journals.

Office of Dietary Supplements (ODS), National Institutes of Health (NIH)

ODS seeks to strengthen knowledge and understanding of dietary supplements by evaluating scientific information, supporting research, sharing research results, and educating the public. Its resources include publications (such as Dietary Supplements: What You Need to Know), fact sheets on a variety of specific supplement ingredients and products (such as vitamin D and multivitamin/mineral supplements), and the PubMed Dietary Supplement Subset.



Key References

  • Elder (Sambucus nigra L.) Natural Standard Database Web site. Accessed at on May 26, 2009.
  • Elder flower. In: Blumenthal M, Goldberg A, Brinckman J, eds. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Lippincott Williams & Wilkins; 2000:103–105.
  • Elderberry. Natural Medicines Comprehensive Database Web site. Accessed at on May 29, 2009.
  • Elderflower. Natural Medicines Comprehensive Database Web site. Accessed at on May 29, 2009.


This publication is not copyrighted and is in the public domain. Duplication is encouraged.

NCCIH has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your primary health care provider. We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by NCCIH.

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NCCIH Publication No.: 
August 2007
April 2012